What does a doula do?

Doulas pride themselves in the shared belief that all birthing people should birth the way they want. We believe in evidence-based information and human agency. We want you to know all the information needed to make an informed choice, and we support you all the way through. As a doula, I do not bring what I would choose for my own personal choices into my support, because I understand we all have different needs, desires, backgrounds, and destinations. Any good doula aims to meet their clients where they are at. We work for you. We know clients hire us for many different reasons. One part of a doula’s job is to be a source of information, education and resources, as well as referrals for what we don’t know or do not provide. It’s important to me to present information wholly. When my clients and I discuss things such as medical interventions, things like fetal monitoring, IV’s, and epidurals, we will look at it in terms of the acronym BRAIN: Benefits, Risks, Alternatives, Intuition, and Nothing. So, let’s take fetal monitoring. A benefit is being able to hear baby’s heartbeat the whole time, which some birthing people find comforting. Some birthing facilities will use continuous fetal monitoring, where, you guessed it, the baby’s heartbeat is being recorded continuously. In some cases, one can go mobile, and a wireless electronic fetal monitoring device is used. Intermittent fetal monitoring is when baby’s heartbeat is checked a couple times during labor, the intervals being closer together as labor progresses. So, perhaps a risk for my client would be not having the freedom to move about, because in the case of traditional EFM, the machine is hooked up to straps that go around the birthing person’s abdomen, which mostly keeps them in or near their bed. An Alternative my client could consider is to ask for the mobile EFM, or to have baby’s heartbeat checked intermittently. In some cases, a Doppler is an option, which provides the auditory sounds of the baby’s heartbeat. The care provider will also usually want to feel the contractions by placing their hands on the birthing person’s abdomen. After my clients and I have talked through BRA, they make their decision, usually having consulted their care provider first, which I strongly recommend all my clients do. This is important because you cannot assume what your birthing facility's policies and procedures are. It is also always important to refer back to your doctor or midwife because this is their expertise. Other times, the choice is the one my clients came in with, which is perfectly amazing. Both of these scenarios are Intuition. N, the last letter in the acronym, stands for Nothing, which perhaps in this case for my client can mean choosing to do nothing and letting things progress on their own. In this case, it could be deciding to forego asking your care provider what they use or what options they provide and going with the flow. Maybe you want to let your care facility do what they normally do. The BRAIN acronym allows birthing people to learn what they need and ask the necessary questions to make an informed decision.

As a doula, I am privileged and honored when a client welcomes me into their birth space. Because we met previously at least two times, I know what you desire for your birth experience. You and I discussed the things you wanted to hear that may be motivating and comforting. We talked about various positions to try in labor and you noted the ones you really thought you’d like to try. Since we chatted about what to bring along in your hospital or birth center bag, you have your favorite fueling snacks and a water bottle with a straw so that I can, without being asked, bring the straw to your mouth after a contraction to keep you hydrated. Doulas also come with their own instinctual wisdom, that I believe is the cherry on top to doula support. We know birth. We often speak of this connection with our clients, that comes from our love and knowledge of the birth process, and the love for and knowledge of our clients undertaking this journey. This bond moves us to know or at least possess in our metaphorical (and sometimes literal) doula toolkits, the mechanisms to support you in labor. We adjust to what you need in the moment. Doulas are a seamless addition to your birth team. When birthing people have partners that will be present during labor, they or their partner may worry about how a doula will mesh. I can confidently say, it is only a few minutes into the labor that they are both quickly aware and delighted by the teamwork we provide together. I actually truly believe that partnerships are strengthened by a doulas presence because the partner and doula merge as a force. Your partner, possessing the deep understanding of you, and your doula, with their expertise in birth, forming the perfect team that puts YOU first. A doula also allows your partner to fully be able to engage in the birth experience with you. The partner can also now be taken care of as well, because doulas provide continuous support. So, if your partner needs a nap, or wants a bathroom break, they can feel comfortable doing so, and you can too, knowing you will not be alone and without support.

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